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约束治疗和双手训练对脑瘫患儿的功能影响:一项随机对照试验。

Functional impact of constraint therapy and bimanual training in children with cerebral palsy: a randomized controlled trial.

机构信息

Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

出版信息

Am J Occup Ther. 2012 Nov-Dec;66(6):672-81. doi: 10.5014/ajot.2012.004622.

Abstract

OBJECTIVE

We compared children's self-care performance and caregivers' perception of children's performance on functional goals established for children with hemiplegic cerebral palsy (CP) after unimanual constraint-induced movement therapy (CIMT) or hand-arm bimanual intensive training (HABIT).

METHOD

Sixteen children with CP were randomized to the CIMT or HABIT group. Interventions lasted for 15 days, 6 hr/day, totaling 90 hr. We used the Pediatric Evaluation of Disability Inventory and the Canadian Occupational Performance Measure (COPM) to assess the children's daily functioning and mixed analyses of variance to compare group means on functional test scores before and after intervention.

RESULTS

Both groups showed significant improvements on functional measures. Group × Assessment interaction in COPM performance revealed greater improvements for the HABIT group after intervention (p = .04).

CONCLUSION

The results suggest that specificity of training exists only for performance of specific goals established by parents and that both CIMT and HABIT can be used to increase children's daily functioning.

摘要

目的

我们比较了偏瘫脑瘫(CP)儿童在接受单手约束诱导运动疗法(CIMT)或手-臂双手密集训练(HABIT)后,在为其设定的功能目标上的自我护理表现和照顾者对儿童表现的感知。

方法

16 名 CP 儿童被随机分配到 CIMT 或 HABIT 组。干预持续 15 天,每天 6 小时,总计 90 小时。我们使用小儿残疾评估量表和加拿大职业表现测量(COPM)来评估儿童的日常功能,并使用混合方差分析来比较干预前后功能测试得分的组均值。

结果

两组在功能测量上都有显著的改善。COPM 表现中的组×评估交互作用表明 HABIT 组在干预后有更大的改善(p=0.04)。

结论

结果表明,只有在父母设定的特定目标的表现上存在训练的特异性,而且 CIMT 和 HABIT 都可以用于提高儿童的日常功能。

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